May 26, 2020 0 Comments

Compre o eBook Interpretação Clínica do Metabolismo Hidroeletrolítico e do equilíbrio hidroeletrolítico, ou seja, da água, dos sais e do distúrbio ácido-básico. Hiponatremia é o distúrbio hidroeletrolítico mais comum em pacientes hospitalizados. A presença de hiponatremia está associada a uma série de desfechos. dissociação proteino-citológica relativa (6) e séptica (4), hipoglicorraquia moderada (4%), hipoglicorraquia severa (4%), distúrbio hidroeletrolítico (3%).

Author: Ker Kajigrel
Country: Germany
Language: English (Spanish)
Genre: Relationship
Published (Last): 12 April 2016
Pages: 429
PDF File Size: 13.96 Mb
ePub File Size: 13.8 Mb
ISBN: 779-9-23920-225-7
Downloads: 64524
Price: Free* [*Free Regsitration Required]
Uploader: Faera

We divided the abnormal results into two groups: These symptoms are not specific, and may be interpreted as clinical manifestations of the underlying disease.

The correlation between the Pandy and Nonne reactions and the lumbar puncture might depend upon the greater protein concentration in this region. The CSF results were correlated to clinical data using Epi-info, version 5. For example, a moderate acute hyponatremia may be more symptomatic than a severe chronic hyponatremia. With a similar methodology, we found Treatment The proper management of hyponatremia requires the consideration of several aspects, such as the duration and severity of the disorder, the presence or absence of symptoms and etiological diagnosis.

Syndrome of inappropriate secretion of antidiuretic hormone SIADH after treatment with cyclophosphamide, alpha-interferon and betamethasone in a patient with multiple myeloma. Our results in HIV-positive patients are very different, indicating that they may have less specific manifestations. There was little correlation between the clinical data and the CSF syndromes.


When faced with a hyponatremic patient, the first step should be to rule out pseudohyponatremia. The most common cause of hypertonic hyponatremia is hyperglycemia, but it can also occur during the administration of hyperosmolar ionic contrast.

Riella Disturbios Hidroeletroliticos – Capítulo do livro de Nefrologia de Riella

Impact of hospital-associated hyponatremia on selected outcomes. Establishing an etiological diagnosis also helps to determine the most appropriate sodium chloride solution normal versus hypertonic saline. However, it has been described in HIV-positive patients, since early in the infection. The syndrome of inappropriate antidiuresis. Because hidrosletrolitico is a fraction, the result may be altered by changes in the numerator total body sodium or in the denominator plasma water in which the sodium is dissolved.

Hence, hyponatremia may be the result of any of the situations shown in Table 1. There were 20 patients between 14 and 25 years old, 68 between 26 and 45 and 12 patients between 46 and The objective of this paper is to comment on six years results of CSF analysis performed to evaluate symptomatic HIV-positive patients, presenting to emergency rooms with acute alterations of consciousness.

Evaluation of the patient with hyponatremia.

Hyponatremia in psychogenic polydipsia. Let’s consider the patient presented in the beginning of this article: Isolated xantochromia, with no erythrocytes nor hyperproteinorrachia, present in one case, may reflect seric elevation of bilirrubins. Euvolemia There should be an absence of hidroeldtrolitico and physical examination data suggesting hypo or hypervolemia.


Metab Brain Dis ; Up to Date, v. J Am Soc Nephrol ; This is a peculiar situation, since dilute urine suggests that the renal ability to excrete water is maintained. A possible mechanism for severe symptomatic hyponatremia during sibutramine therapy.

Taking this into account, in about one fifth of cases the CSF analysis can offer useful information for treatment.

Joyce SM, Potter R.


Although vaptans were indicated, such medications are still unavailable for clinical use in Brazil Table 6. Waiting for more specific manifestations may delay the diagnosis of treatable diseases, like bacterial or fungal meningitis.

Acute consciousness compromise in a HIV-positive patient has many possible etiologies. Berl T, Rastegar A. So, if the renal capacity to excrete water is maintained, a person would need to ingest more than 16L of water to develop hyponatremia.

Ellison DH, Berl T. Given the high frequency of antibodies against Toxoplama gondii in asymptomatic HIV-positive patients, this might be interpreted with caution 9.

Unlike plasma osmolality, there is no single laboratory data that determines the volume status of a patient. When hypertonicity is reversed by the correction of hyperglycemia or renal elimination of the contrast material, serum sodium concentration is normalized.